The first time I saw his name, I knew I probably would never forget it for a very long time to come.  He was assigned to be my patient; I was responsible for his care.

The man was a 40-something-year-old Native American originally from North Dakota.  He was from the Standing Rock Sioiux Nation.  Six feet, five inches tall, rather big: had to easily weigh over 400 pounds easily.  Long, greasy-looking black hair that fell to the middle of his back.  Piercing black eyes, as black as midnight.  A strong hawk nose.  Rough, ruddy skin. He was in the hospital for a diabetic crisis, but he had other health problems as well, so caring for Sam was a challenge.

Besides diabetes, Sam Kicking Horse had congestive heart failure.  COPD that required the use of oxygen 24 hours a day.  Kidney failure (the man was on dialysis treatment several times a week).  Poor circulation: his legs were swollen and discolored.  High blood pressure.  Cataracts in both eyes.  Rheumatoid arthritis that rendered him wheelchair-bound.  

He was a medical mess, to put it mildly.

Anyway, I was in charge of his care, as were several other nurses assigned to the medical floor:  Tatum Orringer.  Gloria M. Trainor.  Julie "Jules" Montanegra.  Adam "Ski" Klowotski.  Michael Henry.  Rachael Digglesworth.  Frank C. McVeigh.  A total of eight different nurses were in charge of giving Sam Kicking Horse the best care possible and to help him lest a crisis should happen to arise.  

His latest crisis happened last night.  Dyspneic (difficult) breathing and rapid (tachycardic) heartbeat.  His vital signs were poor.  We ended up popping him into the ICU overnight; apparently, they got him stable enough to move him back to our floor.  He is still not doing great, but he is doing a lot better than he was last night, according to Edna Voss, the nighttime charge nurse.  So it is up to us to make sure he stays stable.

Not an easy thing to do, since his diabetes is so uncontrollable.  One minute, his blood sugar levels are low; the next, high.  We are always having to monitor everything: breathing/heart rate, sugar levels, kidney function (the guy voided several times, which was more than he did when he first came in), and other factors.  Sam Kicking Horse keeps us hopping.

So does his family.  Sam is married to Wanita and they have six kids: three boys, three girls, who range in age from 2 on up to 19.  Wanita is always wanting the latest up to date information regarding her husband's care/prognosis; I keep telling her to talk to her doctors, as we nurses aren't allowed to divulge a great deal of information.  She hardly gives us a moment's rest.

When something isn't going well, she is one who wants answers.  Right now, not tomorrow, according to her.  Wanita is very demanding and a big pain in my ass.  She is quickly becoming a big annoyance factor to the staff here.  We are not very fond of her.

Well, Sam's heart monitor is beeping, so I'd best see to it and see what is going on.    Hopefully it isn't anything more than a loose connection (lead coming loose) or a minor blip in his heart rhythm: those monitors can be mighty sensitive sometimes ...

~As written by Jane E. Doe, R.N., Nashville, Tennessee.